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This study aims at investigating handwashing behavior during COVID-19 pandemic. It was hypothesized that social-cognitive and emotional predictors as well as COVID-19 morbidity and mortality rates within the country would be associated with handwashing behavior in the general population of adults in 14 countries.
This observational study aims at testing the adherence to handwashing guidelines (the World Health Organization, WHO, 2020) at two measurement points, spanning 1 month. Adults from the general population in 14 countries (Poland, Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Portugal, Romania, Singapore, Switzerland) will provide self-report data on handwashing behavior and its social-cognitive predictors (perceived effectiveness of handwashing, risk perception, outcome expectancy, self-efficacy, intention, planning, and action control), anxiety, as well as COVID-19 morbidity and mortality rates within the country.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Poland | Adults, general population, N = 400 |
| |
| Australia | Adults, general population, N = 400 |
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| Canada | Adults, general population, N = 400 |
| |
| China | Adults, general population, N = 400 |
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| France | Adults, general population, N = 400 |
| |
| Gambia | Adults, general population, N = 400 |
| |
| Germany | Adults, general population, N = 400 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country |
|
| Measure | Description | Time Frame |
|---|---|---|
| Handwashing adherence | The 12-item self-report measure of adherence to handwashing guidelines across situations (e.g., after visiting public spaces, after touching garbage, etc.) based on the guidelines issued by the World Health Organization and the Centers for Disease Control and Prevention. The responses are provided on a 4-point scale, ranging from 1 (strongly disagree) to 4 (strongly agree). Higher scores indicate better outcomes (the higher level of adherence to handwashing guidelines). | 1 month |
| Frequency of handwashing | The 1-item self-report measure of the frequency of handwashing (for at least 20 seconds, all surfaces of the hands) daily. The responses are provided on a 4-point scale, ranging from 1 (less than once) to 5 (more than 10 times). Higher scores indicate better outcomes (the higher frequency of handwashing). | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Self-efficacy | 4 self-efficacy questionnaire items; mean item score ranging from 1 to 4, higher scores indicate stronger self-efficacy | 1 month |
| Risk perception | 3 questionnaire items to assess risk perception; mean item score ranging from 1 to 5, higher scores indicate higher risk perception |
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Inclusion Criteria:
Exclusion Criteria:
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Adults in 14 countries are recruited using the snowballing method. Data are collected using an online platform (software: Qualtricts).
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| Name | Affiliation | Role |
|---|---|---|
| Aleksandra Luszczynska, PhD | SWPS University of Social Sciences and Humanities | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| the University of Melbourne | Melbourne | Australia | ||||
| University of New Brunswick |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | World Health Organization. Coronavirus disease (COVID-19) advice for the public. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public | ||
| Background | Centers for Disease Control and Prevention. When and how to wash your hands. 2020. https://www.cdc.gov/handwashing/when-how-handwashing.html | ||
| 27049339 | Background | Reyes Fernandez B, Knoll N, Hamilton K, Schwarzer R. Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap. Psychol Health. 2016 Aug;31(8):993-1004. doi: 10.1080/08870446.2016.1174236. Epub 2016 Apr 26. | |
| 21767036 |
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The lead researchers in 14 countries will have full access to data collected across the countries.
In line with the Consortium Agreement (v2, 16th Jul 2020) data will be openly available under following conditions:
De-identified individual participant data that underline the results reported in publications; individual-level aggregated data (e.g., sum scores for scales) used for main analyses in respective publications; available following the publication, no end date of availability; available for analyses that are conducted to achieve aims in the approved proposal.
Due to local regulations, there are exceptions in terms of data sharing rules (stated above):
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| Type | Date | Date Unknown |
|---|---|---|
| Release | May 9, 2023 | |
| Reset | Jan 26, 2024 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| May 9, 2023 | Jan 26, 2024 |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001008 | Anxiety Disorders |
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D001523 | Mental Disorders |
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
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| Israel | Adults, general population, N = 400 |
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| Italy | Adults, general population, N = 400 |
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| Malaysia | Adults, general population, N = 400 |
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| Portugal | Adults, general population, N = 400 |
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| Romania | Adults, general population, N = 400 |
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| Singapore | Adults, general population, N = 400 |
|
| Switzerland | Adults, general population, N = 400 |
|
| 1 month |
| Outcome expectancy | 4 items assessing positive (1 item) and negative (1 items) outcome expectancies; mean item scores ranging from 1 to 4, higher scores indicate more positive outcome expectancies | 1 month |
| Intention | 2 questionnaire items assessing intention to adhere to handwashing recommendations; mean item scores ranging from 1 to 4, higher scores indicate stronger intention to wash hands (for at least 20 seconds, all surfaces of the hands) | 1 month |
| Planning | 2 questionnaire items assessing action planning (1 item) and coping planning (1 item); mean item scores ranging from 1 to 4, higher scores indicate a higher level of self-reported planning | 1 month |
| Action control | 3 questionnaire items assessing a facet of action control, namely self-monitoring; mean item scores ranging from 1 to 4, higher scores indicate a higher level of self-reported monitoring of handwashing behavior | 1 month |
| Perceived effectiveness of hand hygiene | 1 questionnaire item assessing perceptions of handwashing as an effective means of preventing coronavirus SARS-CoV-2 infection; item scores ranging from 1 to 4, higher scores indicate a higher level of perceived effectiveness of hand hygiene | 1 month |
| Anxiety | 7-item self-report scale (Generalized Anxiety Disorder, GAD-7) scale to assess anxiety symptoms; mean item scores ranging from 1 to 4, higher scores indicate a higher level of generalized anxiety | 1 month |
| Country-level COVID-19 morbidity and mortality rates | The daily cumulative numbers for COVID-19 morbidity and mortality in the study countries. Published daily as the Situation Report by World Health Organization, starting on 21 January 2020. Higher numbers indicate the higher cumulative COVID-19 morbidity and mortality rates in the country. | 60 days |
| Fredericton |
| Canada |
| Peking University | Beijing | China |
| University of Bordeaux | Bordeaux | France |
| Freie Universität Berlin | Berlin | Germany |
| Bar-Ilan University | Ramat Gan | Israel |
| University of Padova | Padova | Italy |
| Perdana University | Serdang | Malaysia |
| SWPS University of Social Sciences and Humanities | Wroclaw | Lower Silezia | 53-328 | Poland |
| University of Lisbon | Lisbon | Portugal |
| Babes-Bolyai Unversity | Cluj-Napoca | Romania |
| Nanyang Technological University | Singapore | Singapore |
| University of Zurich | Zurich | Switzerland |
| London School of Hygiene and Tropical Medicine (in collaboration with MRC Unit The Gambia at LSHTM) | Fajara | The Gambia |
| Background |
| Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol. 2011 Aug;56(3):161-70. doi: 10.1037/a0024509. |
| Background | Ruiter RAC, Abraham C, Kok G. Scary warnings and rational precautions: A review of the psychology of fear appeals. Psychol Health. 2011;11(1): 613-630. doi: 10.1080/08870440108405863 |
| 36436259 | Derived | Szczuka Z, Siwa M, Abraham C, Baban A, Brooks S, Cipolletta S, Danso E, Dombrowski SU, Gan Y, Gaspar T, Gaspar de Matos M, Griva K, Jongenelis M, Keller J, Knoll N, Ma J, Abdul Awal Miah M, Morgan K, Peraud W, Quintard B, Shah V, Schenkel K, Scholz U, Schwarzer R, Taut D, Tomaino SCM, Vilchinsky N, Wolf H, Luszczynska A. Handwashing adherence during the COVID-19 pandemic: A longitudinal study based on protection motivation theory. Soc Sci Med. 2023 Jan;317:115569. doi: 10.1016/j.socscimed.2022.115569. Epub 2022 Nov 21. |
| 34871341 | Derived | Luszczynska A, Szczuka Z, Abraham C, Baban A, Brooks S, Cipolletta S, Danso E, Dombrowski SU, Gan Y, Gaspar T, de Matos MG, Griva K, Jongenelis MI, Keller J, Knoll N, Ma J, Miah MAA, Morgan K, Peraud W, Quintard B, Shah V, Schenkel K, Scholz U, Schwarzer R, Siwa M, Taut D, Tomaino SCM, Vilchinsky N, Wolf H. The Interplay Between Strictness of Policies and Individuals' Self-Regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic. Ann Behav Med. 2022 Apr 2;56(4):368-380. doi: 10.1093/abm/kaab102. |
| 34610808 | Derived | Szczuka Z, Abraham C, Baban A, Brooks S, Cipolletta S, Danso E, Dombrowski SU, Gan Y, Gaspar T, de Matos MG, Griva K, Jongenelis M, Keller J, Knoll N, Ma J, Miah MAA, Morgan K, Peraud W, Quintard B, Shah V, Schenkel K, Scholz U, Schwarzer R, Siwa M, Szymanski K, Taut D, Tomaino SCM, Vilchinsky N, Wolf H, Luszczynska A. The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries. BMC Public Health. 2021 Oct 5;21(1):1791. doi: 10.1186/s12889-021-11822-5. |
| D012141 |
| Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |